A very interesting week in Birmingham

Last week Councillors and Local Government officers from across the country gathered in Birmingham for the Annual Conference, with some exciting backdrops on the Agenda.

As always it seems the ‘U ‘ question (unitary councils bids such as Buckinghamshire, Oxfordshire and now Leicestershire lead the way) hangs in the air as it has done for a number of years. There was to be the maiden conference speech by a new SoS James Brokenshire MP and last but not least the previous week a key report was published jointly by the Health and Social Care and Housing, Communities and Local Government Committees. It makes for fascinating reading in the coming debate on Health and Social Care and indeed ahead of the much delayed Green Paper on Social Care now due in the Autumn a whole year after it was promised.

You can download it from the http://www.parliment.uk website by clicking the link below.

https://www.parliament.uk/business/committees/committees-a-z/commons-select/communities-and-local-government-committee/inquiries/parliament-2017/long-term-funding-of-adult-social-care-17-19/

Almost as a footnote last week, but no less interesting is an article by Tony Travers for http://www.lgcplus.com. Tony is one of the most respected speakers on Local Government finance and when he rings the warning bell its time to listen. the link to his article which makes for sobering reading is here:

https://www.lgcplus.com/services/health-and-care/tony-travers-nhs-is-on-course-to-consume-all-public-expenditure/7025020.article

On a personal note, I was delighted to get re-elected to the Conservative Executive of the LGA as what is known as an ‘At Large’ Executive Member rather than as the County Council representative for obvious reasons. I am delighted to join a tremendous senior Conservative team as we work to set out the Conservative Agenda at the LGA for the coming year.

Conservative History and Philosophy Seminar

Last week I returned from holiday to attend the much talked about Conservative History and Philosophy Seminar, having kindly been invited along with about 50 or so other Conservatives to discuss the future of Conservative ideology.

The seminar was Chatham House rules so no reporting of what was said, but its theme is important for Conservatives.  So much so, that its speaker list reads like a who’s who of the party, with Brandon Lewis MP, Chairman of the Conservative Party opening the proceedings.  Over the next few hours, we heard from Dominic Johnson CBE Vice Chairman of the party and organiser of the event and from Professor Andrew Roberts, Jesse Norman MP, Jacob Rees-Mogg MP, Anne Jenkin, Baroness Jenkin of Kennington, Neil O’Brien OBE MP, amongst other great speakers.  In the last of the three sessions were heard about the future with speakers ranging from Dr. Eliza Filby and Dr. Anthony Ridge-Newman discussing how society, aspirations and social media are constantly changing.

If you take part in politics at any level, local or national one of the things that has seemed evident is the extent to which the left seeks the moral high ground, s if theirs is the only ‘moral’ way forward.  Well, it’s not, being a Conservatives should come with a conviction that it’s the right and moral way to organise society.  Let’s face it, time and time again socialism has proven to be a failure, it failed here with the last Labour government, and the one before that if like me you are old enough to remember 1979 and it continues to fail across the globe.

The Conservative Party has always been a reforming party, and this work is about making sure that beyond the day job, the party and its activists are thinking about how we reform our society.  How conservative values of hard work, individualism and making sure that success is rewarded not treated with suspicion as socialism would have you believe, has proven to be a success across the globe and with checks and balances is the best way to organise your economy and society.

Many people in the party look back to the Thatcher years with nostalgia.  But it was also a time when the Conservative Party has an ideological basis, as it turned the Hippies of the sixties into the Yuppies of the eighties, was it perfect, of course not, but it had a foundation, a conviction, an ideology.  Today the world is very different, and no one is suggesting a reinvention of Thatcherism. The millennial generation as not the same as when I entered adult life, but the future of the Conservative Party lies in its believes in itself, and its ideology as it shapes local and national policy.

Sadly Council Tax has to rise

Here is my column that appeared in last Tuesday’s edition of the EADT and then in the Ipswich Star.

Last week, Suffolk County Council’s cabinet voted to increase council tax in Suffolk for the first time since 2010.

A 2.99% increase was approved, along with a 2% adult social care precept, meaning taxpayers will be paying little under 5% for council services than last year.

A council tax rise was not surprising – we had mentioned it last year, with a 1.99% increase put forward, with the adult social care precept at 3%.

Despite the changes in the way the tax is being divided, the increase remains the same.

It’s been said that we are taking away the 1% from the precept to spend elsewhere. This is simply untrue. The 1% we’ve added on top of the 1.99% first mentioned in October will go towards providing adult care. There is nothing more important to us than delivering the best possible frontline services to those who need them most.

We spend half a billion pounds providing services every year. Like the majority of councils in England, we accepted a four-year financial package from the Government, covering the period from 2016/17 to 2019/20. It also, helpfully, provides some certainty about our funding.

However, we can’t rely on this alone. We were successful in our bid to be one of 10 areas where we can retain 100% of business rates generated here in Suffolk, which will help. But there still remains a budget gap.

In 2018/19, the gap is £26.8million. That is the difference between the amount of money it will cost to provide essential council services in Suffolk and the amount of money we actually have to spend.

We are required by law to have a balanced budget so we have therefore had to find ways of closing that budget gap. We have proposed a range of savings totalling to £23.9m, leaving us with a gap of £2.9m remaining – which will come from our reserves.

We have been careful to limit the use of our reserves as once that money has been spent it’s gone forever and won’t be available to close any future budget gaps.

This isn’t a new way of working for Suffolk County Council. We’ve successfully managed the financial challenges laid down in the Government’s austerity programme and have made savings of £236 million between 2011 and 2018. The response to these challenges has been measured, pragmatic and innovative, and designed to protect front line services as much as possible.

Demand for services has increased since the last council tax increase and it continues to. We also have an investment programme totalling nearly £100m this coming financial year, which includes building new schools, extending and improving existing schools, investing in Suffolk’s road network, continuing to provide better broadband coverage across the county and delivering two major river crossing projects – the Lake Lothing Third Crossing in Lowestoft and the Upper Orwell Crossings in Ipswich.

Being clear about your goals, listening to people and being accountable for your actions are fundamental principles in public services. When the people of Suffolk voted in the Conservative councillors I lead, it was on the basis of a clear manifesto.

We are introducing business plans, which set out how we will deliver services and how we will measure performance. These are based on three core priorities – inclusive growth, healthcare and wellbeing, and efficient and effective public services.

These are deliverable because of the hard work and commitment of our councillors and staff – working with our partners, businesses and residents to make Suffolk a healthier and more prosperous place to live and work.

Yes, the latest Autumn Budget confirms that the pressure on public spending is likely to continue. But this is not news to us and we have a positive response.

We don’t hang about in Suffolk, we get on and do everything we can to get the best possible outcomes for the people we serve. We do this by listening to what people say and giving them an opportunity to influence the difficult decisions we have to make.

This council tax increase wasn’t taken lightly and every penny will be put to the best possible use. Our staff, our councillors, and I, will make sure of that.

 

A very happy New Year

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I always like to start the year with a reflective blog on last year and a few thoughts about the year ahead.

It was an eventful year with the General election in June and a few weeks earlier the County Council elections at the beginning of May.  At the county elections, I led a strong conservative team of 74 Candidates campaigned on a manifesto for Suffolk.  Voters were excited to vote Conservative and we were returned with a thumping majority with 52 out of 75 Councillors and a majority of 29 with Labour plummeted from 19 to 9! – pinned back into Ipswich with just a couple of seats outside in Sudbury and Lowestoft.  Our manifestos could not have been in starker contrast – ours talking about careful prudent management of the finances and Labours was spend, spend, spend!  We fought every single Division whether we thought we could win it or not, Labour abandoned Rural Suffolk and only fought only in the divisions they targeted, a cynical campaign.

Then we had the General Election and I think it’s fair to say the mood in the country changed during the course of those intervening few weeks and the party lost its slim overall majority.  To me it was a very mixed picture as across Suffolk most of our MPs increased their majority and in particular the very hard-working Peter Aldous cemented his Constituency of Waveney. But the political swing-o-meter began to move dramatically to the left and unfortunately the excellent Ben Gummer lost his seat in Ipswich to the very man who organised such a cynical county council election campaign the County Council labour group Leader Sandy Martin.  The most surreal few weeks I have seen in my political life time and I suspect we will not see the likes of such a dramatic swing again.

With our strong County Mandate, we have set about the budget and the savings we have to make over the next 4-year period coupled with rising demand for services for the most vulnerable in our communities.  But I want this next 4-year term to be more than prudent management of the council I want it to be about the future so we are setting about more ambitious and significant long-term planning than has ever been attempted in Suffolk before.  Together with our partner District and Borough councils, Public Health, the Acute Hospitals and our Clinical Commissioning groups we are working on a string of new strategy documents which once completed this year will be about Suffolk 2050.  I come from the management school of the 4 Ps, poor planning equals poor performance and my very favourite business mantra is ‘aim at nothing and you’ll hit it with remarkable accuracy!’ so the plans will not be party political but about building a broad consensus across the public sector including the health services and with the business community about what we want Suffolk to look like in 2050 and how we get there, in terms of infrastructure, industrial growth, roads rail, social and Health care and the sort of places we want to live in.

Watch this space.

Social Care article for The Guardian

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Week before last I wrote an article for the Guardian Newspaper about the future of social care and things our Government needs to consider as they ponder the way forward:

When you consider the plethora of social care papers that have come and gone down the years, irrespective of governments, you’d be forgiven for taking next summer’s review with a pinch of salt.

Yet, there is a feeling that this cannot go on for much longer. County areas are withstanding some of the greatest pressures in delivering and procuring social care services, coupled with the deepest reductions in core government grants.

If there was an easy answer, we would not be arriving at social care paper number 13.

Any solution must be long-term in its vision, but early noises suggest that next summer’s review could narrowly focus on funding options for older people.

Exploring a wide-range of options to ensure long-term sustainable funding, firstly to meet the £1bn funding gap that counties face in delivering social care, and for the individual to protect them from facing huge care costs, is paramount.

Whilst this is clearly crucial, the County Councils Network (CCN) argues for a more holistic approach, which brings together prevention, housing, workforce, and integration as well as sustainable way to fund social care.

We argue for a culture shift; turning the existing system on its head. It is currently too focused on the end result, or dealing with issues as they arise, rather than exploring ways to mitigate a person’s health troubles. From the individual’s point of view, who wouldn’t want to live healthier and independent longer?

This is best illustrated by how much media airtime delayed discharges get; an example of the reactionary nature of the system. We must shift thinking towards stopping people from entering hospital unnecessarily in the first place instead of institutionalised care; enabling them to be in control of decisions about the type and location of care they receive.

Housing reform will play a big part in this shift of mindset. The ability for people to stay at home and receive care – or at least to choose to do so – is hampered by the lack of adaptable housing, whilst for those exiting hospital, there are not enough reablement and rehabilitation services in England.

Another issue that often slips under the radar is the dearth of retirement property development: with 7,000 built yearly, whilst analysis suggests 30,000 are needed. The need to keep pace with England’s rising elderly population is obvious, but an increased prevalence of care housing and adapted properties will allow people to live independently longer. In turn, this means less demand on social care services and fewer delays in exiting hospital.

The green paper should seek to create the conditions to encourage more development of supported and retirement homes, including reforms to the planning process to better incentivise the building of these properties.

Integration of health and social care has been labelled a solution, especially in reducing demand. Yet for a variety of reasons, the agenda has not had lift-off. Considering that full integration by 2020 as originally planned is unlikely to happen, we should consider reforms to the way the current system works.

Instead of gunning for wholesale change in a short timeframe, government should be considering pooling its NHS and social care budgets as a precursor to full integration. Some counties already are; with councils and local NHS providers making joint decisions based around the individual; with the aim of keeping people out of hospital for longer.

At the same time, the NHS Tariff, which rewards acute trusts for patient contacts rather than outcomes should be reviewed; to reward providers for preventing people from entering crisis care unnecessarily.

In essence, we should try to build a preventative ecosystem that allows people to maintain their health for longer. This means widening the debate, to tightening the links between adult and children’s social care, and crucially, public health services.

It should also aim to ensure those currently ‘in the system’ live as independently as possible. Here, having consistency in carers is vital. Yet Brexit could impact on workforce projections, not least in areas such as Essex where one-third of its care home workforce are EU nationals. CCN is calling for flexibility in immigration rules to allow providers to recruit from Europe should they be unable to internally.

These solutions are only a cog in a much larger machine; there is no silver bullet to making social care sustainable. No-one is under any illusions of how difficult a task this is for a government, least of all an administration that does not have Parliamentary arithmetic on its side.

But without thinking long-term, and a culture shift that brings prevention into focus, next summer’s green paper could ultimately go the same way as its precursors.

Cllr Colin Noble, County Councils Network Spokesman for Health & Social Care and Leader of Suffolk County Council

The link to the article is:

https://www.theguardian.com/social-care-network/2017/dec/07/there-is-no-silver-bullet-for-social-care-but-ministers-must-not-dodge-the-issue?CMP=share_btn_link

 

 

 

As winter approaches

Here’s the column I wrote for the EADT and the Ipswich Star newspapers a couple of weeks ago:

With temperatures noticeably dropping outside, we are on the cusp of the period that causes the most anxiety among health and social care professionals.

As the Leader of a county council, my staff are bracing themselves for the unknown, but putting robust plans in place to ensure any ‘winter crisis’ is kept at bay – as I’m sure councils are doing across the country. However, planning for the forthcoming period and beyond has been made more difficult; with storm clouds gathering between Whitehall and councils because of fraught debates over delayed transfers from hospital.

The context behind this leads back to the government’s much-welcomed additional £2billion for social care last March, showing it was listening to our concerns over the fragility of the social care system.

Councils have invested this money in making the system work better for patients, including raising care home fees, recruiting extra dementia nurses, and expanding rapid response services. This funding has helped reduce delayed discharges, and better supported the care needs of residents.

Initially, completely unrealistic targets were imposed on counties. Subsequently, 32 local authorities received letters asserting that if they do not improve discharge rates by November part of this £2bn funding would be withheld, or, equally concerning, diktats from Whitehall would be issued on how funding should be spent locally.

The imposition of targets and the positioning of NHS England has led to delays in agreeing details of the Better Care Fund (BCF), a further pot of cash for local areas to better integrate health services.

The concerns of Ministers are understandable. Rates of delayed transfers have continued to rise; a real issue for the health service but also a moral issue: no-one deserves to be stuck in hospital longer than they should do.

However, rising delayed discharges should be of little surprise when you consider the factors involved: the funding available for social care, rising demographics and demand, and, in particular whole system performance: two-thirds of delayed days are attributable to the NHS, not councils.

While Suffolk is not one of the 32 authorities that received a letter, just under half of those who were contacted are county authorities. Counties have faced a financial quandary unmatched in local government with 30% less funding per head of over 65s than in 2010 and face a £1bn black-hole in social care funding by 2020/21.

We must consider ways to use money in the system more effectively. This goes to the heart of why the current loggerheads between councils, NHS England, and the Department of Health is counterproductive and potentially highly damaging.

Counties have worked tirelessly with NHS partners to develop BCF plans, providing impetus to reduce demand. The prospect of this funding being withheld or placing it in a national body’s hands, could I fear, only worsen the situation. In this instance, centrally-led initiatives are no substitute for local knowledge and expertise.

Rather than short-term, centralist thinking, I believe we should channel our efforts into prevention and early intervention. People are living longer, meaning they are increasingly likely to have more complex conditions requiring greater levels of care.

This means there is also a need for personal responsibility as well – if people do things such as getting a flu jab, that will reduce the chance of receiving a serious illness and a visit to A&E. If people are unwell they should start by seeing their pharmacist and GP before visiting A&E, allowing those who really need emergency care to get it as quickly as possible.

Government may need to give health and social care additional funding in the Budget for the winter, but Ministers must also give local areas the opportunity to implement their BCF plans and deliver a preventative, community-based, approach.

Those 32 councils threatened with the prospect of having funding withheld must be given time to see the fruits of their labour. If not, investment by councils could go to waste and local partnerships with health will be permanently set back.

Fixing health and social care is not going to happen overnight. They are two very different beasts, multi-layered and steeped in years of bureaucracy and regulations.

That’s why whole-system reform is needed. We have failed to evolve the systems to match the demand, needs, expectations, and ultimately the money available to pay for them. It is this fundamental question we need to focus on in the forthcoming social care green paper, rather than who is to blame for delayed transfers.

Ultimately, it is revolution, rather than evolution, that is needed to unpick the systemic issues that drive the actions of both health and social care. But to make that happen, we need collaboration, not consternation.

My Column in the EADT & Ipswich Star

Every two weeks I write a column for the EADT & Ipswich Star, and at this anxious time of year we learn the A-Level and GCSE results, so here are my thoughts on the picture that emerged in Suffolk:

In the past fortnight, teenagers across Suffolk have been picking up exam results that could shape the rest of their lives.

Weeks and months of hard work has come to an end – for both pupils and staff, as well as governors and parents. For some youngsters, the results won’t be what they hoped. For many however, it will mean they will now be looking at the next stage of their lives.

To those who didn’t do as well as expected – it’s not the end of the world, there’s plenty of opportunities out there you to be a success. For those who excelled, as we’ve seen in many photos of excited students with papers jumping in the air, congratulations.

The results we’ve seen across Suffolk are a testament to the county’s continuing ambition to drive up educational standards.

Provisional A Level figures have shown the number of A*-E grades awarded to the near-3,000 students taking the exams as above the national average – with 98.2% of results making the grade, 0.3% above the average.

Even with the changes and uncertainty in GCSE grading for English and Maths this year, 64% of students achieved expected attainment levels – grade four (previously a grade C) and above – an increase on last year.

A number of schools saw significant increases in their students reaching the grade four threshold – and the hard work of all involved in achieving these should be commended.

More than 7,000 Suffolk students took GCSEs this year and figures collated from schools show a significant increase in the number of disadvantaged pupils achieving the threshold measure in English and maths – around 6% more students in Suffolk achieved this compared to last year.

We are in the process of reinvigorating our Raising the Bar strategy for 2018 through to 2020 and will be sharing more information on that soon, followed by a consultation. In the process of carrying out this work officers have already been out in the sector engaging with school heads to see what they think should be in there.

This strategy aims to give every child the best preparation for life before and beyond school to enable them to achieve their full potential. Part of this vision is for every child to attend a good or outstanding school.

As part of the scheme, we have seen great successes in getting people into teaching through our graduate internship scheme and school to school support partnerships – where schools build relationships to share best practice and drive up standards – have improved throughout the county. These partnerships, of which 75% of schools work in, have been recognised by the Department for Education, as well as the Regional Schools Commissioner.

Suffolk also continues to be above the national average for children achieving a good level of development at the end of Reception year – a vital step in preparing children for their next steps in education and towards our goal of enabling all children in the county to reach their full potential.

Suffolk’s students are progressing well between key stage three and key stage four– moving up 57 places from 112th to 55th across in the national rankings last year, putting our county in the top half of all local education authorities.

When we launched this ambitious approach, Suffolk’s educational standards were considered to be poor – little over two-thirds of schools were rated either ‘good’ or ‘outstanding’ by Ofsted. With hard work and a common goal, the best for our county’s children, we have really managed to turn this around. Today, 88% of schools have been rated ‘good’ or ‘outstanding’ by government inspectors – a 22% increase since the strategy’s launch.

The rate of improvement is fast too – last year our county’s schools reduced the gap on the national average by 5% and we are now just 1% below the national figure.

However, we are under no illusion that our work is complete and while it is extremely pleasing to see the progress made so far, there is still more to be done and I am confident we will see our schools and education settings continue to improve quickly.

The future remains bright for our children – and we will continue to provide the best opportunities for them.

 

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